2014-04-21T08:51:43-05:00 2013-12-31 420732909 RYUN GIVENS & COMPANY PLC 2900 100TH STREET SUITE 301 URBANDALE IA 50322 990 2013-01-01 420713662 THE UNITED PRESBYTERIAN HOME OF WASHINGTON IOWA UNIT 3196535473 1203 EAST WASHINGTON STREET WASHINGTON IA 523532198 MICHAEL D MOORE CEO 3196535473 2014-04-21 1 CURTIS E BRAND CPA P00299230 5152253141 2013 2015-11-30 17:44:51Z MICHAEL D MOORE 1203 EAST WASHINGTON STREET WASHINGTON IA 523532198 5995394 0 X UPHOME.ORG X 1947 IA THE MISSION OF UNITED PRESBYTERIAN HOME, GUIDED BY CHRISTIAN COMPASSION, CONCERN AND STEWARDSHIP, IS TO PROVIDE SENIORS WITH QUALITY SERVICES, CARE AND HOUSING. 16 16 127 109 0 0 1868173 45067 5852604 5900175 24097 50152 0 0 7744874 5995394 0 0 0 0 3413913 3532094 0 0 0 3285215 3202557 6699128 6734651 1045746 -739257 12875444 12430990 8802532 8667285 4072912 3763705 THE MISSION OF UNITED PRESBYTERIAN HOME, GUIDED BY CHRISTIAN COMPASSION, CONCERN AND STEWARDSHIP, IS TO PROVIDE SENIORS WITH QUALITY SERVICES, CARE AND HOUSING. 0 0 6077574 5694846 HOLISTIC APPROACH TO LONG-TERM CARE FOR THE ELDERLY TO MAINTAININDIVIDUAL AT HIGHEST PRACTICAL LEVEL OF FUNCTIONING. PROVIDED HOUSINGAND NURSING CARE PATIENT DAYS: ICF 8,558, SKILLED 1,449, MEDICAID7,462, ASSISTED LIVING AND RESIDENTIAL 48,370 FOR A TOTAL OF 65,839PATIENT DAYS. 6077574 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 1 127 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL D MOORE 3196535473 1203 EAST WASHINGTON STREET WASHINGTON IA 523532198 JAMES E LLOYD CHAIR 2.00 X X 0 0 0 ROBERT G HUBER VICE-CHAIR 2.00 X X 0 0 0 JIM CUDDEBACK TREASURER 2.00 X X 0 0 0 DEBORAH SCHOENFELDER DIRECTOR 2.00 X 0 0 0 REV FORREST KRUMMEL DIRECTOR 2.00 X 0 0 0 CHARLES E POLAND DIRECTOR 2.00 X 0 0 0 DAVID MAUPIN DIRECTOR 2.00 X 0 0 0 RICHARD K SCHMIDT DIRECTOR 2.00 X 0 0 0 SANDY DUNLAP DIRECTOR 2.00 X 0 0 0 JEAN ROBERTSON DIRECTOR 2.00 X 0 0 0 BILL STEWART DIRECTOR 2.00 X 0 0 0 BRUCE WALKER DIRECTOR 2.00 X 0 0 0 JOANN TORPEY DIRECTOR 2.00 X 0 0 0 NANCY ROSS DIRECTOR 2.00 X 0 0 0 JOHN THORNE DIRECTOR 2.00 X 0 0 0 JOHN STALEY DIRECTOR 2.00 X 0 0 0 MICHAEL D MOORE CEO 50.00 X 139190 0 16250 ERIN DRAHOTA COO/ADMINISTRATOR 40.00 X 47574 0 7410 186764 0 23660 1 0 0 0 MORRISON MANAGEMENT SPECIALIST 5801 PEACHTREE DUNWOODY RD ATLANTA GA 30342 FOOD MANAGEMENT CONTRACTOR 892466 AEGIS THERAPIES INC 7160 DALLAS PARKWAY STE 400 PLANO TX 75024 THERAPY CONTRACTOR 337549 SHAW ELECTRIC INC 930 EAST RIVER DRIVE DAVENPORT IA 52803 GENERAL CONTRACTOR 226257 ALLIANT UTILITIES 4902 NORTH BILTMORE LANE SUITE 100 MADISON WI 53718 UTILITIES SERVICES 211017 JOHNSON CONTROLS 5757 N GREEN BAY AVE MILWAUKEE WI 53201 CONTROL SERVICES 114240 5 45067 45067 RESIDENT SERVICES 623000 3398662 3398662 MEDICAID/MEDICARE PAYM 623000 2296184 2296184 DAY CARE 623000 105788 105788 MEALS 623000 99541 99541 5900175 50152 50152 5995394 5694846 0 255481 210423 210423 2870589 2767959 102630 59232 53309 5923 152994 140804 12190 238856 214586 24270 17430 17430 6987 6987 28086 5068 23018 88128 40619 47509 784027 714123 69904 4951 4951 351569 351569 692127 692127 49637 49637 MEDICARE COSTS 353495 353495 SUPPLIES AND EQUIPMENT 302862 302862 FOOD AND SUPPLEMENTS 286984 286984 LOSS ON BOND REFINANCE 117782 117782 118492 97445 21047 6734651 6077574 657077 0 26441 37195 1184388 704295 334457 282479 31742 33489 207 159 23958049 13838519 9946665 10119530 799168 619534 552376 634309 12875444 12430990 419521 457599 4445618 4449562 3787912 3641073 77337 51966 72144 67085 8802532 8667285 X 3098763 2769664 392359 412251 581790 581790 4072912 3763705 12875444 12430990 X -739257 47107 382943 X 0 1 X 1 0 X 123143 109473 152344 1868173 45067 2298200 4694260 5075565 5685851 5640884 5694846 26791406 168798 167584 176232 211721 205329 929664 4986201 5352622 6014427 7720778 5945242 30019270 76984 27906 49835 56425 37909 249059 0 76984 27906 49835 56425 37909 249059 29770211 9932 11093 23309 22590 50152 117076 9932 11093 23309 22590 50152 117076 4996133 5363715 6037736 7743368 5995394 30136346 0.98790 0.98980 0.00390 0.00280 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 581790 581790 575819 6389 418 581790 581790 -5554 417 575819 575607 14163 7980 581790 493511 82531 435 575607 1.00000 1 0 116913 116913 21015173 12264227 8750946 2825963 1574292 1251671 10119530 CONTRIBUTION RECEIVABLE FROM REMAINDER TRUST 406501 DEFERRED BOND COSTS 43795 ENDOWMENTS RECEIVABLE 184013 634309 REFUNDABLE ENDOWMENTS LIABILITY 9251 RESIDENT LOANS PAYABLE 57834 67085 6062393 47107 19892 66999 5995394 0 5995394 6734651 0 6734651 0 6734651 PART V, LINE 4: THE ENDOWMENT FUNDS ARE TO BE USED FOR BENEVOLENT AND CHARITABLE CARE FOR RESIDENTS, EMPLOYEE RECOGNITION AND EDUCATION, AND OPERATIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN VALUE OF CHARITABLE REMAINDER TRUSTS 19,892. FORM 990, PART VI, SECTION B, LINE 11 THE POLICY OF THE BOARD OF DIRECTORS IS TO PRESENT THE FORM 990 TO THE FULL BOARD OF DIRECTORS INCLUDING SIGNIFICANT SCHEDULES. EACH MEMBER OF THE BOARD OF DIRECTORS WILL RECEIVE A COPY OF THE FORM 990 PRIOR TO SUBMISSION OF THE FORM TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO READ AND UNDERSTAND THE CONFLICTS OF INTEREST POLICY, AND ALL BOARD MEMBERS ARE REQUIRED, ON AN ANNUAL BASIS, TO COMPLETE AND SIGN AN ANNUAL STATEMENT OF COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 WHEN HIRING THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES, AND THEREAFTER ON AN ANNUAL BASIS, THE BOARD WILL PERFORM A THOROUGH REVIEW TO DETERMINE SUITABLE COMPENSATION. THE PROCESS INCLUDES A REVIEW OF COMPARABILITY DATA BY THE BOARD OF DIRECTORS OR AN INDEPENDENT COMPENSATION CONSULTANT. EACH YEAR THE BOARD WILL REVIEW THE COST OF LIVING INDEX, LEADINGAGE IOWA WAGE AND BENEFITS SURVEY, YEARS OF SERVICE AND THE LEADINGAGE NATIONAL WAGE AND BENEFIT SURVEY. THE BOARD WILL RETAIN DOCUMENTATION OF THE DELIBERATION AND FINAL DECISION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS OFFICE IN WASHINGTON, IOWA. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF CHARITABLE TRUST RECEIVABLE 19,892. PRIOR PERIOD ADJUSTMENT 363,051.